Entrar/Registro  
HOME SPANISH
 
Cirujano General
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Cirujano General >Year 2004, Issue 4


Justo JJM, Prado OE, Theurel VG, Rosa PR, Lozano EA
Ambulatory laparoscopic cholecystectomy. A good alternative
Cir Gen 2004; 26 (4)

Language: Español
References: 12
Page: 306-310
PDF: 4. Kb.


Full text




ABSTRACT

Introduction: The current treatment for chronic lithiasic cholecystitis is laparoscopic cholecystectomy. The experience acquired by surgeons has allowed decreasing the time of hospital stay leading to propose it even as an ambulatory procedure. Since the first reports (1990), the specialized centers refer a yearly increment in the procedure reaching a success rate of 70 to 97% in the programmed ambulatory laparoscopic cholecystectomies (ALC). Objective: To report the experience in a general hospital from the Ministry of Health with an ALC program in a 10-year period. Setting: Second level health care hospital. Patients and methods: Patients programmed for ALC that accepted the procedure, with ASA I, II, and III classification, with a car, not outsiders, and who were admitted at 7.00 hs, operated before 14.00 hs, and discharged maximally at 20.00 hs, with oral tolerance, and after anesthetic and surgical assessment. Analyzed variables were: age, gender, pre-operative diagnosis, associated diseases, surgical technique, surgical time, complications, causes for conversion, time of stay in recovery, oral tolerance, pain, re-admittances, causes for the failure of the ambulatory procedure, and post-operative complications. Results: In 10 years, 1025 cholecystectomies were performed; 565 (55.12%) were laparoscopic, 405 (71.7%) were programmed to be ambulatory, and from these 75.5% were accomplished successfully; 17% were men and 83% were women, average age 40.5 years (14-85), surgical time 25 to 155 min; 302 corresponded to lithiasis and 4 to polyposis; recovery time averaged 6 hours (3-9). In 99 patients the discharge had to be delayed due to: conversion (26), pain (19), vomiting (18), administrative cause (17), outsider (15), and patient’s preference (4). Conclusion: The most important factor for failure was conversion. Physical condition, obesity, associated diseases or duration of surgery had no impact on the results. An ALC program is feasible and safe to implement in a general hospital caring for an open population.


Key words: Cholecystectomy, laparoscopy.


REFERENCIAS

  1. Reddick EJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy. Am J Surg 1990; 160: 485-7; discussion 488-9.

  2. Huang A, Stinchcombe C, Phillips D, McWhinnie DL. Prospective 5-year audit for day-case laparoscopic cholecystectomy. Br J Surg 2000; 87: 362-73.

  3. Robinson TN, Biffl WL, Moore EE, Heimbach JK, Calkins CM, Burch JM. Predicting failure of outpatient laparoscopic cholecystectomy. Am J Surg 2002; 184: 515-8; discussion 518-9.

  4. Lam D, Miranda R, Hom SJ. Laparoscopic cholecystectomy as an outpatient procedure. J Am Coll Surg 1997; 185: 152-5.

  5. Lau H, Brooks DC. Contemporary outcomes of ambulatory laparoscopic cholecystectomy in a major teaching hospital. World J Surg 2002; 26: 1117-21.

  6. Voyles CR, Berch BR. Selection criteria for laparoscopic cholecystectomy in an ambulatory care setting. Surg Endosc 1997; 11: 1145-6.

  7. Dubois F, Berthelot G, Levard H. Cholecystectomie par coelioscopie. Presse Med 1989; 18: 980-2.

  8. Gutierréz L, Grau L, Rojas A, Mosqueda G. Colecistectomía por laparoscopia. Informe del primer caso realizado en México. Endoscopia 1990; 3: 99-102.

  9. Calland JF, Tanaka K, Foley E, Bovbjerg VE, Markey DW, Blome S, et al. Outpatient laparoscopic cholecystectomy: patient outcomes after implementation of a clinical pathway. Ann Surg 2001; 233: 704-15.

  10. Pérez CE, Ostos MLJ, Mejía DAF, García FMC. Colecistectomía laparoscópica ambulatoria. Rev Med Inst Mex Seguro Soc 2002; 40: 71-5.

  11. Mondragón SR, Saldívar MC, Castillero PCM, Ruiz MJM, Oñate OLF, Aiello CV. Carcinoma primario de la vesícula biliar. Rev Gastroenterol Mex 1997; 62: 189-93.

  12. Mjaland O, Raeder J, Aasboe V, Trondsen E, Buanes T. Outpatient laparoscopic cholecystectomy. Br J Surg 1997; 84: 958-61.






>Journals >Cirujano General >Year 2004, Issue 4
 

· Journal Index 
· Links 






       
Copyright 2019